Social care funding gap in England 'can be plugged'

By Nick Triggle Health correspondent, BBC News

Ministers are looking to reform social care

Continue reading the main story

Social care

• Why social care has to change
• Q&A: Social care
• Case studies: Life in the system
• How village life can help

The funding gap for reforming social care in England could be plugged by raiding the NHS surplus or restricting access to benefits such as the winter fuel allowance, experts say.

A review published last year suggested care costs should be capped, but this would cost an extra £1.7bn a year.

The Nuffield Trust analysis believes this sum could be found from within existing public sector spending.

The think-tank said tax rises could be used too.

But it questioned whether that would be appropriate in the current financial climate and said if they were to be introduced they should be targeted at elderly people.

The report comes as the government is still finalising its plans for reforming the way people pay for care in their own homes and in care homes.

A White Paper is expected to be published next month.
Controversy
One of the proposals under consideration is the idea of introducing a cap on lifetime care costs of between £35,000 and £50,000.

Continue reading the main story

“Start Quote

If you were starting with a blank sheet of paper is this the best balance of spending to ensure quality of life, dignity and respect in older age?”

End Quote Anita Charlesworth Nuffield Trust

This was put forward by the Dilnot Commission, which was set up by the government to look into the issue.

Funding is the most controversial element of the changes, with the Treasury thought to have concerns about the cost to the public purse of reforming the system.

By 2026, the estimated additional annual cost of £1.7bn is likely to rise to £3.6bn because of the ageing population.

But the Nuffield Trust said it was feasible to look at redistributing current spending to cover the bill.

It pointed out that about £140bn a year is spent on elderly people across the NHS, welfare and social care sectors.

Just 6% of this currently goes on social care.

The Nuffield Trust said the extra cost could be plugged through a variety of measures.

For example, it cited a £1.5bn underspend in the NHS last year.

Money could also be saved by means-testing benefits such as winter fuel payments, travel concessions and free TV licences.

Report author Anita Charlesworth said it was important that the government had an open debate with the public about priorities.

"The government currently spends some £140bn a year on older people.

"If you were starting with a blank sheet of paper is this the best balance of spending to ensure quality of life, dignity and respect in older age?"

Michelle Mitchell, of Age UK, agreed, saying an "honest debate" was needed and she urged ministers to have "courage and conviction" in their attempts to reform the system.

The government said it would be publishing its plans soon.
http://www.bbc.co.uk/news/health-18241298

Carers Kensington & Chelsea Events for Carers Week

Carers Kensington & Chelsea Events for Carers Week
18 – 24 June 2012

This year Carers Kensington & Chelsea would like to invite all Carers to join us at:
Monday 18th June 12pm - 4pm Carers Health Day, THT Lighthouse, 111-117 Lancaster Road, Ladbroke Grove, London, W11 1QT

Look after yourself with a massage or seated massage, talk with a health trainer about becoming healthier or attend a stress busting workshop.

There will be free refreshments too.You need to book your massage session – please see details below.

Wednesday 20th June 11am - 3pm Carers Week Information Day
Small Hall in Kensington Town Hall, Horton Street, London, W8 7NX

Come and find out what support is available for carers. There will be speeches from the Chief Executive of Carers UK, Councillor Hargreaves and others and you can enjoy a free delicious lunch too!

Thursday 21st June 12pm - 4pm Carers Stress Bustling Relaxation Day Chelsea Theatre, 7 Worlds End Place, London, SW10 0RD.

The reality of caring can be stressful – come and relax with free Yoga and Meditation workshops for carers. Free refreshments will be provided. You need to book your workshop sessions – please see details
below.

And if that was not enough, how about taking a break with coffee and a piece of cake? , Sloane Square, SW1W 8EL is offering 25 carers café vouchers for use at Peter Jones Café during Carers Week.
All our events are free of charge.

If you would like to book a massage session and/or a place on a yoga or meditation session and/or a Peter Jones voucher call our freephone on 0800 0321089. If the phone goes through to voicemail please leave your name and phone number and tell us which session or sessions you would like to attend. Or email
us at kandc@carersuk.org

Inclusion London Social Care Event - 12th June 2012

02/05/2012

Social Care in the 21 Century- the reality and the vision 

Free event: What social care do we need?  What’s working and what needs to change?

Help shape Inclusion London’s and Age UK London’s response to the Government’s imminent white paper on social care.

Date: 12 June
Time:  11am – 4.30pm
Venue:  SCOPE, 6 Market Road, London, N7 9PW.

The event is primarily for older and disabled people and will include presentations on social care, including the recommendations from the Dilnot Commission and Law Commission on who should get social care and how to fund it, plus the initial results of Inclusion London’s Social Care survey. Group discussions which give an opportunity voice your views and experience.

More information about the social care survey is available at:www.inclusionlondon.co.uk/tell-us

To book your place, please fill in the booking form and return to Age UK London, by Thursday 7 June to:
Email: JAldridge@AgeUKLondon.org.uk
Tel: 020 7820 6770   
Post:  Age UK London, 21 St George’s Road, London SE1 6ES

More information regarding the consultation event is available from:
JAldridge@AgeUKLondon.org.uk
henrietta.doyle@inclusionlondon.co.uk

Please forward this invitation to your contacts, especially to disabled people who may be interested.

Book your place, please fill in the booking form below.

Social Care 21 Booking Form

Do you employ a Personal Assistant -Businesslink tool - taking on an employee in 5 easy steps

Business link has created a tool to help people employing for the first time:

http://www.improve.businesslink.gov.uk/resources/tools/taking-employee

Decide how much you should pay someone

• What you must do:

  You need to make sure you pay at least the national minimum wage.
  The national minimum wage rate will depend on the age of your worker and the type of work they do.

• Why you must do it:

  If you pay less than the minimum wage you will be required to make up the shortfall and pay a fine.
  If you refuse to pay the national minimum wage on purpose you may be prosecuted, resulting in a criminal conviction and penalty.
  Your worker can also take you to an employment tribunal if you fail to pay them at least the minimum wage. 

• How you can do it:

  Use our tool to check that you are complying with national minimum wage law.

More on pay obligations.

More

Check if someone can legally work for you

• What you must do:

  Before you offer someone a job you need to check that they have the legal right to work in the UK.
  
  You need to check and keep copies of certain documents before your worker starts. The documents you need to check will depend on the type of worker you are employing.

• Why you must do it:

  If you unknowingly employ someone who doesn’t have the right to work in the UK, you can face a fine of up to £10,000 per worker.
  
  If you knowingly employ someone who doesn’t have the right to work in the UK you will face a more severe penalty such as a prison sentence.

• How you can do it:

  Use our tool to check your worker’s right to work in the UK.
  Understand your data protection obligations when keeping copies of your worker’s documents.
  Contact Acas to find out if you have to make any other checks.

More on other legal checks you might need to make.

More

Get employment insurance

• What you must do:

  When you become an employer, you must take out an employers’ liability (EL) insurance policy. Your policy must be with an authorised insurer, must cover you for at least £5 million and must cover all your employees in England, Scotland, Northern Ireland and Wales.
  
  You must also display your EL compulsory insurance certificate or make it available to Health & Safety Executive (HSE) inspectors when they ask.
  
  If you’re only employing a family member or someone who is based abroad, you don’t need compulsory EL insurance.

• Why you must do it:

  Under the law, you are responsible for having the right insurance and for checking that your insurer is authorised.
  
  The HSE is responsible for enforcing the law on EL insurance. You can be fined up to £2,500 for each day that you do not have appropriate insurance.
  
  If you do not display your EL compulsory insurance certificate or refuse to make it available to HSE inspectors when they ask, you can be fined up to £1,000.

• How you can do it:

  Check that your insurer is authorised by consulting the Financial Services Authority (FSA) Register.

More on employers’ liability insurance.

More

Register and pay your worker for the first time

• What you must do:

  When you take on an employee for the first time, you normally need to register as an employer with HM Revenue & Customs (HMRC) to ensure you deduct the right amount for PAYE (Pay as You Earn) and National Insurance contributions.
  
  You will need to make PAYE payments when you pay your workers more than a certain amount.
  
  Once you have done this, you must provide your employee with a list of the deductions you have made from their pay in writing.

• Why you must do it:

  The fine for not registering as an employer is calculated according to how late you are in registering.
  HMRC charges late payment penalties on PAYE amounts due that are not paid in full on time. The minimum fine is £50, but it could be more. 

• How you can do it:

  Check if you need to register with HMRC.
  Register with HMRC.
  Find out what deductions you need to make from your employee’s pay.
  Information about issuing pay statements to employees.

More on pay obligations, including providing a payslip.

More

Send details of the job in writing to your worker

• What you must do:

  If you’re employing someone for more than a month, you need to provide them with a written statement of employment within their first two months.
  
  

• Why you must do it:

  If you don’t provide your employee with a written statement of employment, you may be taken to an employment tribunal.
  
  If the employee’s claim is successful, the tribunal will award a compensation of two to four weeks' pay. A week's pay for this purpose is subject to a statutory limit. For the current limit, see our table of current tribunal compensation limits.

• How you can do it:

  Use our tool to create a written statement of employment.
  Guidance on putting together an employee’s written statement of employment.

More on writing contracts and written statements.

More

Burstow urges social workers to overhaul 'crisis' care system - Community Care Magazine

Burstow urges social workers to overhaul 'crisis' care system

The care services minister has put social workers at the heart of his plans to transform social care from a "high-dependency service" to one that supports people to stay independent. Minister Paul Burstow says social workers are critical to the success of his care reforms.

Mithran Samuel

Friday 18 May 2012 13:43

 

Social workers will be at the heart of plans to transform social care from an "unsustainable, crisis service” to one based on promoting well-being, through the forthcoming White Paper.

That was the message from care services minister Paul Burstow in a speech to Community Care Live yesterday, in which he said social workers’ role would shift from care managing and brokering services for those who meet eligibility thresholds towards helping people avoid the need for formal care and support altogether. This would be through working with older and disabled people to build community networks and use their strengths and assets to reduce isolation, build resilience and help people live active, fulfilling lives.

“Some people call it local area co-ordination, some call it connected care and others call it asset-based community development, he said. “Simply put, it is a vision for social work that is no longer based on [reacting] in a crisis.” While this was not about “prescribing practice”, Burstow said the government was determined to see this approach to social work spread beyond the “few areas” where it currently exists.

While he did not specify how the government’s support for this approach would be articulated in the White Paper and the consequent draft bill on social care reform, he said social work would be “critical” to their success. Burstow admitted that local authorities faced pressures on their adult care budgets, but said that this meant “acting as a high-dependency, crisis service [was] unsustainable”, and that it was necessary to "radically change the way we think about and deliver social care in a way that chimes with the asset-rich approach".

Association of Directors of Adult Social Services president Sarah Pickup also called for a switch in council resources towards prevention, in a subsequent session on the White Paper yesterday.

"We will always spend most of our budget on people with the highest needs - those with lifelong learning disabilities or people with dementia who need 24-hour care," she said. "But we need to push enough of our budget into prevention and reablement to prevent people who shouldn't need ongoing care from having to receive it."

However, unlike Burstow, Pickup said social workers' skills were best deployed in working with people with the highest needs to make choices and lead more fulfilling lives.

Concerns were expressed at the conference about councils reducing social workers' roles in adult care. However, Pickup said: "If you are working with troubled families or supporting people with lifelong conditions to have the best possible life, this requires social work skills."

"There's a lot of work to do; the biggest pressure on our budgets is in learning disabilities" she added. "There's no danger of social workers being written out of the script."

The approaches Burstow is advocating

• Local area co-ordination involves a practitioner working in particular localities to help individuals (about 50-65 at any one time) build confidence and independence and fulfil their goals, by building relationships with them, providing information and connecting them with community resources. It has been rolled out in Scotland and is being tested in some areas in England and Wales.
• Asset-based community development involves practitioners mapping and mobilising the "assets" within a community, particularly the skills and knowledge of residents and the full range of community groups, to affect positive changes. More information is available from the Scottish Community Development Centre.
• Connected care has been developed by social care organisation Turning Point to involve members of communities in designing services around their needs, in partnership with commissioners and practitioners.

http://www.communitycare.co.uk/Articles/18/05/2012/118220/burstow-urges-social-workers-to-overhaul-crisis-care-system.htm

Test case could outlaw critical threshold for adult care

Councils could be prevented from restricting adult social care to meeting people's 'critical' care needs by a legal challenge brought on behalf of five disabled people.

Mithran Samuel

Monday 21 May 2012 08:50

 

Councils could be prevented from only funding service users' critical care needs under a test case that could result in thousands of older and disabled people gaining access to care.
West Berkshire Council, one of three councils with a critical threshold, along with Northumberland and Wokingham, is being challenged by five severely disabled residents currently denied the support they need in a challenge supported by the charity Mencap.
They are being represented by solicitors Irwin Mitchell, which successfully overturned moves to raise eligibility thresholds by Birmingham and Isle of Wight councils last year. While those cases succeeded because the two authorities failed to adequately assess the impact of the increased rationing of care on affected service users, this latest challenge focuses on the legality of setting a critical threshold itself.
Councils with critical thresholds do not provide formal care and support to meet people's 'substantial' needs; these include an inability to carry out the majority of personal care tasks, or to undertake the majority of family or social roles, or suffering, or being at risk of, abuse or neglect, as opposed to serious abuse or neglect.
The five clients are:-

• Siblings Z and F, who have learning disabilities and autistic-like behaviours, and need support to be available around-the-clock for daily living and domestic tasks;
• SW, who has a severe learning disability and epilepsy and is need of constant supervision;
• HB, who has a mild learning disability and has been assessed by the council as vulnerable to abuse and exploitation by her peers;
• AT, who has diagnoses of autism and epilepsy, no speech, very limited communication abilities and displays behaviours that challenge.

"Many severely disabled people across the country rely heavily on the support that is offered by social care services, but not all of those fall under the umbrella of what is deemed 'critical'. This policy in West Berkshire leaves our clients and possibly thousands of others both potentially vulnerable to harm and isolated from their local communities."
West Berkshire Council has declined to comment while the case is ongoing.
What is the basis of the challenge?
Irwin Mitchell argues that the critical threshold is in breach of section 2 of the Chronically Sick and Disabled Persons Act 1970, which places a duty on councils to provide a range of community care and support services for disabled people where local authorities determine that such provision is necessary in order to meet the needs of a disabled person.
In a landmark judgement in 1997 (R v Gloucestershire County Council, ex parte Barry), the House of Lords ruled that councils could take their resources into account in applying section 2.
However, in setting out the judgement, Lord Nicholls of Birkenhead said that councils needed to act in a "responsible fashion" and treat disabled people "reasonably". Irwin Mitchell will contend that setting a critical threshold is unreasonable and that the judges in the Barry case could not have envisaged that their judgement could have been used to justify such a threshold.
The Fair Access to Care Services guidance, which established the four-band eligibility framework for adult social care (critical, substantial, moderate, low), came into force in 2003, six years after the Barry judgement.
http://www.communitycare.co.uk/Articles/21/05/2012/118222/test-case-could-outlaw-critical-threshold-for-adult-care.htm 

Home care, stealth tax and the elderly: which councils charge the most?

A significant reduction in the number of older people getting care for free, or partly funded by the council means a vast difference in costs. Which councils charge the most and which have the lowest rate?
• Get the data

The postcode lottery of social care has been exposed by a survey of local authories in England revealing big increases and wide variations in council charges for home care services that help frail and vulnerable older and disabled people, the Guardian can reveal.

Freedom of information requests to 120 councils show that home care services - which send carers to help vulnerable older and disabled people get up, washed, dressed and fed - are becoming more expensive and inaccessible to large swathes of the population.
There are wide disparities in the price people pay for care depending on where they live. Home care is free in Tower Hamlets, but it costs £21.50 per hour in Brighton and Hove. The data shows that more than 7,000 fewer older people had care fully paid for by their local authority in 2011 compared to 2009, a drop of 11%.
   With the government delaying its plans to tackle the country's underfunded social care system, the rising cost of home care, says Labour's Liz Kendall, is effectively a "stealth tax on the most vulnerable people in society".
The survey, given exclusively to the Guardian, shows the average charge for an hour of home care has increased by 10% in the last two years – from £12.29 to £13.61. Kendall points out that an average elderly person pays for 10 hours of home care a week and will have seen their bills rise to £7,077 a year in 2013 – up more than £680 since 2010.
With elderly voters' already smarting from the "granny tax" in March's Budget, Kendall warns that "fewer older people are getting their care for free, and more older and disabled people are being forced to pay more. These services are a lifeline for older and disabled people and crucial to help them stay living independently in their own homes."
The tables below show the highest hourly charges and the lowest including details of the party in control. What can you do with the data?

Data summary

Highest hourly charges (2012/13)

Click heading to sort table. Download this data

Council	Price, £	Pre-May	Post May
Source: FOI requests
Brighton & Hove Council	21.50	Grn (min)	Grn (min)
Worcestershire County Council	20.60	Con	Con
West Berkshire Council	20.00	Con	Con
Royal Borough of Kingston Upon Thames	18.22	Lib	Lib
Buckinghamshire County Council	18.00	Con	Con
Wokingham Borough Council	17.90	Con	Con
Central Bedfordhire Council	17.80	Con	Con
London Borough of Lambeth	17.67	Lab	Lab
Bedford Borough Council	17.60	NOC	NOC
Cambridgeshire County Council	17.44	Con	Con
Royal Borough of Windsor and Maidenhead	17.00	Con	Con
North Yorkshire County Council	16.90	Con	Con
North Somerset Council	16.80	Con	Con
Slough Borough Council	16.68	Lab	Lab
Solihull Metropolitan Borough Council	16.65	Con	Con
London Borough of Merton	16.64	Lab (min)	Lab
London Borough of Waltham Forest	16.45	Lab	Lab
Cornwall County Council	16.28	Con	Con
City of York Council	16.00	Lab	Lab
Wandsworth Borough Council	15.80	Con	Con
Coventry Metropolitan Borough Council	15.58	Lab	Lab
South Gloucestershire Council	15.16	Con (min)	Con
Wiltshire County Council	14.85	Con	Con
Bracknell Forest Borough Council	14.80	Con	Con
London Borough of Bromley	14.64	Con	Con
Norfolk County Council	14.62	Con	Con

Lowest hourly charges (2012/13)

Click heading to sort table. Download this data

Council	Price, £	Pre-May	Post May
Source: FOI requests
London Borough of Tower Hamlets	0.00	Lab	Lab
Sandwell Metropolitan Borough Council	7.00	Lab	Lab
Trafford Metropolitan Borough Council	8.92	Con	Con
Oldham Metropolitan Borough Council	9.50	Lab	Lab
Liverpool City Council	9.70	Lab	Lab
Calderdale Metropolitan Borough Council	9.90	Lab/Lib	NOC
St Helens Metropolitan Borough Council	10.08	Lab	Lab
Knowsley Metropolitan Borough Council	10.20	Lab	Lab
Gateshead Metropolitan Borough Council	10.50	Lab	Lab
Warrington Borough Council	10.61	Lab	Lab
East Riding of Yorkshire Council	10.70	Con	Con
Stockton-on-Tees Borough Council	10.76	Lab/Ind	Lab
Sunderland City Council	10.84	Lab	Lab
London Borough of Hackney	11.00	Lab	Lab
South Tyneside Metropolitan Borough Council	11.00	Lab	Lab
Blackburn with Darwen Borough Council	11.04	Lab	Lab
North East Lincolnshire Council	11.24	Lab (min)	Lab
Leicester City Council	11.25	Lab	Lab
Doncaster Metropolitan Borough Council	11.28	NOC	Lab
Halton Borough Council	11.35	Lab	Lab
Blackpool Borough Council	11.50	Lab	Lab
Rutland County Council	11.50	Con	Con
Stockport Metropolitan Borough Council	11.65	LD (min)	NOC
Derby City Council	11.72	Con/Lib	Lab
Newcastle Upon Tyne Council	11.72	Lab	Lab
Lincolnshire County Council	11.93	Con	Con

Free home care available to fewer elderly people - Guardian

Free home care available to fewer elderly people

Older and disabled people suffer postcode lottery over fees as numbers who have home care paid by local council fall 11%

• Randeep Ramesh, social affairs editor
• The Guardian, Wednesday 16 May 2012
• Comments (9)

Home care costs have increased with the average hourly charge rising by 10% in the past two years – from £12.29 to £13.61.

 

The number of vulnerable older and disabled people who had home care services fully paid by their local authority fell by 11% in England in the past two years, according to newly published figures.
The data also reveals wide variations in council charges across England.
Freedom of information requests to 120 councils revealed that home care services – which send carers to help vulnerable older and disabled people get up in the morning, and get washed, dressed and fed – are becoming more expensive and inaccessible to many of the population.
And there are wide disparities in the price people pay for care depending on their location. Home care, for example, is free in Tower Hamlets but costs £21.50 an hour in Brighton and Hove.
The data show that fewer older people – in excess of 7,000 – had their care services fully paid for by a local authority in 2011 a reduction of 11% compared to 2009.
With the government delaying its plans to tackle the underfunded social care system the rising cost of home care was branded a "stealth tax on the most vulnerable people in society", by Liz Kendall, the Labour MP for Leicester West.
The survey, seen by the Guardian, shows the average charge for an hour of home care has risen by 10% in the past two years – from £12.29 to £13.61. Kendall said that an average elderly person paid for 10 hours of home care a week and would have seen bills rise to an annual £7,077 in 2013 – up more than £680 since 2010.
Elderly voters are seen to be already smarting from the "granny tax", announced in the March budget. Kendall warned that fewer older people were getting their care for free, and more older and disabled people were being forced to pay more. "These services are a lifeline for older and disabled people, and crucial to help them stay living independently in their own homes," she said.
Home care is means tested and councils have varying "eligibility criteria": eight in 10 councils now only provide care for people with "substantial" or "critical" needs. Only those who meet council eligibility tests and have savings of less than £14,250 are entitled to free care.
Charities said that the price rises, which affect the poorest and most vulnerable, were "disgraceful". The Alzheimer's Society said: "Many people with dementia and their carers are already struggling to pay for home care and some may not be able to afford the increased prices. The extortionate costs in some parts of the country don't even guarantee good quality care. This is disgraceful. Home care services are vital in helping to maintain quality of life for people living with dementia."
Labour claims the government, despite promising to protect social care services, has cut more than £1bn from local council budgets for older people.
Many councils cap the weekly costs the elderly are required to pay for home care. But in a sign of how difficult funding has become for social care, almost half of the councils that reported having a ceiling on costs have now removed this.
Local authorities warned that things were "only going to get much worse" with the government imposing a 28% funding cut over the next four years.
David Rogers, chair of the Local Government Association's community wellbeing board, said: "The sad reality is, these findings aren't surprising.
Unless we see urgent reform of how care is provided to our rapidly aging population things are only going to get much worse … the cost of adult social care already takes up more than 40% of council budgets and we are very close to a point where failure to address the crisis in social care funding could set the long-term solution back years."
Many in the sector warn that the corollary of cuts without reform is charges in social care becoming more prevalent.
"There are political decisions about charging. The bottom line is that we only have so much money to spend before we have to look at a charging policy," said Sarah Pickup, president of the Association of Directors of Social Services.
However the government insists there is enough money in the system for local authorities to pay for elderly care. The care services minister, Paul Burstow, said the government was working on "cross party agreement" on social care funding. "Councils decide whether and how much to charge for home care services and the current system of charging has been around since the 1980s. In the spending review the government recognised the pressures on the adult social care system, and took the decision to prioritise adult social care by allocating an additional £7.2bn up to 2014/15."
http://www.guardian.co.uk/society/2012/may/16/free-home-care-elderly-people

Councils 'failing to assess needs of carers of people with autism'

Survey finds four out of five carers have not been through assessment process that councils are obliged to provide

• Peter Walker
• guardian.co.uk, Monday 21 May 2012 11.17 BST
• Comments (6)

 

Only one in five carers of people with autism have ever received the local authority assessment of their needs to which they are legally entitled, according to a major survey of carers' needs.
Of more than 5,500 carers who filled in an online survey for the National Autistic Society (NAS), 80% said they had never been through the assessment process, which local authorities are obliged to provide and which helps them obtain the right assistance. Only 26% of those who responded said they received any help at all from a council or health authority.
More widely, campaign groups warn that poor information about support services coupled with spending cuts and wider economic worries have caused significant difficulties. "We call it a perfect storm for carers," said Emily Holzhausen, policy director for Carers UK.
"Those juggling work and care feel more under pressure at work, benefits are under review and we also have rising charges and changes to services. The pressure is really loading up on families, and we see that through our helpline – we're getting calls from very distressed people."
The NAS figures, part of a wider study that also examined the problems faced by people with autism, found more than three-quarters of carers said they had been obliged to battle to receive support services.
The survey highlighted the extreme toll placed on those placed in such situations. More than 80% of the carers said the lack of support had caused them anxiety, with 64% saying it was a cause of depression. More than half said being a carer had directly affected their own mental health.
The study tallied with carers' accounts given the NAS helpline and to individual branches, said Sarah Lambert, head of policy for the charity.
She said: "People say they are having to fight to get the help they need, and that has quite a significant effect on their own mental health and their relationships. Increasingly, with cuts to local services there will be gaps, for example fewer short breaks or respite services available, which can make that even more challenging."
While it could be tempting for local authorities to view carer assessments as an expensive obligation, this was wrong, said Holzhausen.
"It might be easy for someone to say, this is another bureaucratic process – what does it add? It adds a huge amount. Not taking into account how the carer is doing is really a false economy. A lot of people really are pushed to breaking point, and then the cost to a local authority really rockets, for example if someone needs residential care."
Carers' groups are calling on the government to address the situation in the upcoming social care bill, one of those highlighted in this month's Queen's speech. They particularly want the bill to include recommendations from a three-year study into adult social care by the Law Commission, also published this month.
The commission report recommends that assessments also "focus on the carer's ability to provide and to continue to provide care for the person cared for", taking into account factors such as whether the carer can balance their duties with enough time for work, education and leisure

We cannot afford to delay social care funding reforms - Guardian

We cannot afford to delay social care funding reforms

The government's draft bill does not look like it will tackle the growing crisis, or the cynicism and dispair that many feel,

• • Melanie Henwood
  • Guardian Professional, Friday 11 May 2012 08.30 BST
  • Comments (2)

It fell to Justine Greening, the transport secretary, to try to offer reassurance about social care after the Queen's speech.

The Queen's speech has confirmed what many of us feared: there is to be a draft care and support bill, but the focus will be primarily on legal reform and measures "to modernise adult care and support in England". There is no mention of reform of the funding system or how to ensure fairness in funding that protects individuals against the catastrophic costs of care.
Modernisation of the care system, and of the legal framework that defines it, is certainly overdue. Since the National Assistance Act of 1948, incremental reform and the emergence of new legislative provisions has created a labyrinthine and anachronistic legal framework that is now scarcely fit for purpose. The extensive work of the Law Commission (which reported last year) has demonstrated the scope and scale of the change required to "create a clear, modern and effective legal framework for the provision of adult social care both now and for the future".
This is not simply a question of consolidating legislation and tidying up legal anomalies. A new framework will also need to address some fundamental issues around the delivery of care, including: a national approach to eligibility, portability of assessments and duties on local authorities to provide adequate information and advice; closer integration of health and care; and continuing promotion of personalisation in order to achieve greater choice and control for people using services.
The anticipated white paper on social care reform (that was expected around Easter) has still to appear but the health secretary indicated last year that it would offer "full proposals for the reform of adult social care" and "a progress report on funding reform". The content of the draft bill serves to underline that separation of two branches of reform. However, the overhaul of the legal framework without parallel reform of the funding system is flawed and incomplete.
Earlier this week, a coalition of 78 charities and campaign groups sent an open letter to the prime minister cautioning against such an approach, advising that "social care is in crisis. The system is chronically under-funded and in urgent need of reform." That sense of urgency does not seem to have percolated through to the coalition government.
Alongside the report of the Law Commission, that of the Dilnot commission on the funding of care and support (published in July 2011) also requires a response. Following the state opening of parliament on Wednesday, ministers were busily touring the broadcasting studios doing their best to reiterate their commitment to continuing cross-party talks on funding social care and getting a solution that sticks for the long term. Albeit sounding less than familiar with the detail of the issues, it fell to Justine Greening, the transport secretary, to tell The World at One that the task "is difficult and too often governments have pushed it off. We don't intend to do that, but we do want to try and get it right first time."
Such assurances may not be enough to counter the growing cynicism and despair felt by many. The nature of the challenge with paying for care is well understood and has been explored in depth by repeated commissions and inquiries; there has been ample time for progress to be made – this growing crisis has not suddenly appeared overnight but has been steadily building for a generation or more. The fear is that the draft bill will not move things on at the pace that is now required It is unlikely, although possible, that legislation could begin in the autumn and reform be put in place during this parliament, but the concern must be that the wheels continue to turn very slowly and uncertainly. Successive governments have wrestled with this same dilemma and failed to grasp the nettle (because however the finances stack up this will not come cheap); the prospects of doing so at a time of continued financial restraint and a flat-lining economy look bleak.
It is right, of course, that reform must not only be done quickly but be done well, but that cannot be an excuse for further protracted delay of the major changes that are required. For many thousands of people it is already far too late; elderly and disabled people who are struggling to meet the costs of care, or to get access to care for which they don't meet the increasingly restrictive eligibility criteria, will take little comfort from the assurances that work is ongoing. Many more face the prospect of growing old with the fear and uncertainty of not knowing how they will cope or what will happen if they cannot meet the costs of care. The inclusion of a draft bill on care and support reform is better than nothing, but the overwhelming sense is of unfinished business and a massive funding gap that has still to be tackled.

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